Stories and thoughts from day to day life in the Bullard Family

A thorough book on infant and child sleep written by a pediatrician and father of four. The book is broken into three sections: 1) How children sleep, 2) How parents can help their children establish healthy sleep habits, and 3) Other sleep disturbances and concerns.

The first section describes healthy sleep, disturbed sleep, sleep problems, and common myths. Five elements of healthy sleep are introduced here and reiterated several times throughout the book. The reader cannot forget this point, as Weissbluth uses this as a building block for how the infant can develop healthy sleep habits; all five must be in place. This section also outlines strategies for getting the infant or young child to sleep. These include soothing methods and sleep methods. The sleep methods include “no cry,” “maybe cry,” and “let cry.” He goes into detail of what these methods look like theoretically and anecdotally.

Like many other sleep solution books, the author gives what he considers to be the ideal and healthy sleep schedule. However, he does not say that it is critical to follow this schedule if you want your child to sleep. He gives many alternative solutions and variations of the sleep schedule, keeping the needs of the family in mind. He gives proposed solutions for almost any kind of problem that could come out of a sleep schedule. Prevention, treatment and action plans are offered as concrete guidance for different sleep issues.

This book also covers the extremely fussy baby, or colic. There is an entire chapter dedicated to it. This information is basically reprinted in Weissbluth’s other book, “Your Fussy Baby.”

The second section focuses on what sleep looks like at different developmental stages. So, for infants aged 0-3 or 4 months, sleep patterns are broken down by week. He also takes into consideration the colicky baby who is not likely to follow this pattern. Months 5-12, 13-36, preschool children, and school-age and adolescents are covered. The author explains what is healthy for that age range, what is “average,” and how the parent can help the child to achieve optimum sleep habits.

The third section discusses other sleep problems and concerns, such as sleep walking, nightmares, bedwetting, the arrival of a new sibling, moving from a crib to a bed, travel, illness, and several other situations that might effect sleep habits. This section is helpful in that it provides enough information of how the issue might disturb sleep, but does not go in to the issue itself. For example, eczema might disrupt sleep because the child may be itching in the night and unable to sleep.

The information in the book is based on research. Studies abound to support suggested sleep methods and he also uses anecdotal evidence collected from his years as a pediatrician. There is almost everything one would need to know about infant and child sleep in this book. The methods for getting the child to sleep are a little weak and is not a focal point in the book. Some step-by-step instructions exist to teach parents how to train the child to stay in his or her crib or recognize when the child is getting sleepy or when he or she is over-tired.

My take on the book:

Weissbluth seems to be trying to provide information, not counsel on how to actually get the child to sleep. I find this helpful, because I can then make an informed decision of how I want to “parent” my child in this area, whether it be co-sleeping or having the child in his own crib and using the “let cry” method of sleep training. The instruction to actually getting your child to sleep is not very clear and I would not feel confident using these techniques with my child. However, it is very informative and educational. I feel like I really understand our son’s sleeping better, though he isn’t actually sleeping all that well. I know we have work to do, but when we do start “training,” it will be much easier because we will not be fighting his biological sleep rhythms.

For specific sleep training techniques, I would recommend the following books:

In my obsession with sleep, I can tell you exactly how much my baby is averaging per week. I have this data from the day he was born. I can’t imagine how much I would guess he sleeps. It would either be more than what he actually gets, or less, depending on how stressed out I’m feeling. Tracking his sleep helps me keep it real, so to speak.

If you work and your baby is on a schedule, say waking up at the same time everyday and going to bed at the same time and sleeping on the day care nap schedule, then you probably have a pretty good idea of how much sleep he or she is getting. If you are home with your child/ren, then it might be more difficult to tell how much sleep he or she gets because the day is just not that cut and dry. Unless you have one of those babies who sleeps when you want them to, there has to be some way of keeping track of it all.

We tracked our daughter’s daily happenings for 18 months. Sounds a bit neurotic, perhaps. But we then understood her much better without having to impose our unreliable memories or stressed perspectives on her. It helped us to respect her natural sleepy times and active times. Most of all, it helped us make sure she was getting enough rest, something that is hard to come by for people of all ages these days.

When establishing a schedule for an infant, it is suggested by several sleep “experts” that you mark wake and sleep times for a few days so that a pattern can be seen. After 14 weeks of tracking Gabriel, we are still waiting for a pattern. Actually, there is a pattern: he falls back to sleep about an hour after waking. Great! So rather than fight his cries (“How can he be tired, he just woke up!”), I can head him off at the pass and put him down. I’m hoping to find some more patterns as he moves through the fourth month. Then we can begin shaping his patterns to ones that are better for him and us. This might be earlier bed times, regular naps, regular night feedings, and establishing a clear routine for these things.

More to come on how we will embark on the adventure of sleep training. And hopefully reap great rewards of sleeping for more than 90 minutes at a time!

I am so grateful for this book. It is the only book on parenting that has made me feel okay about my child. The author has raised four children, one of which happened to be “fussy.” He is also a pediatrician and has extensively studied sleep disorders / sleep issues in children. According to this book, about 20% of babies are considered “extremely fussy.” Using the term “fussy” sounds negative and we all know what happens when we label a child: they become the label. But let’s say that you could use the label because the individual fits the definition and the definition helps you feel more sane about what is going on. Weissbluth states ad nauseam that all babies get fussy for no apparent reason. It is just that some babies fuss considerably more so than others and he calls these babies “extremely fussy” or the old-school label: “colicky.” Ewwww, no one wants to hear this when talking about babies. But the fact of the matter is our little boy fit right into this category.

How is the fussy baby defined? Extremely fussy / colicky babies cry (or fuss) for more than 3 hours per day, at least 3 days per week, for at least 3 weeks duration. That, to me, seems like a mild definition. But this is the criteria for an extremely fussy baby. Now, to the review:

This book, though quite small, is loaded with information about colic. The introduction really caught my attention with two sentences: that the book is “based on the belief that an informed parent is an effective parent” and “Parents are better able to soothe fussy babies when they understand why newborn babies fuss” (p. xxiii). And it is so true.

It opens by outlining several studies that try to uncover what causes such a condition. Basically, all studies on colic over the past 100 years simply show what does not cause extreme fussiness. The author’s wife shed some light on the subject when investigating the role of melatonin and seratonin in extremely fussy babies. This was the only study in the book that found any positive correlation between any variable and the fussy baby.

The idea that temperament might play a part is discussed and clearly explained. There are many variables and possibilities for how nature and nurture interact in this area. Weissbluth gives several examples of how the extremely fussy baby can be soothed, such as rhythmic rocking motions, swaddling, and lullabies.

The part of the book most helpful to me was the presentation of sleep patterns of extremely fussy babies and what the parent or caregiver can do about them. He gives clear advice of how to avoid sleep problems once the colic has ended at around three or four months.

The author presents the information in an objective way, and maintains consistency of his opinion regarding sleep and causes and treatment of colic throughout the book. He gives different options for people to choose to approach the extremely fussy baby based on lifestyle choices and what the research says is most effective. He gives examples of how to breastfeed or bottle feed and co-sleep or use a crib. These are generally the big issues that divide people on whether to use a certain technique or not. He also gives options for using gradual extinction or just extinction (let cry some vs no cry). I found this to be helpful, since one will often act out of character when faced with a desperate situation.

My take on the book:

I liked this book so much, I borrowed his other book, “Healthy Sleep Habits, Happy Child” from the library. I thought “Solve Your Child’s Sleep Problem” was the best book, but this one might be better in that it gives you options for how to approach sleep training. This book helped me to accept my fussy baby for who he was and that it isn’t something he can help doing. He isn’t “playing” me; babies don’t know how to do that when they are this young.

Our son has gotten better, aside from his sleep (which is basically horrible). He is happy, smiling and quite easy now at 3 months.

It is natural for parents to go through a period of getting little to no sleep at all during the infant’s first few weeks. Some lucky parents get to experience this for the first few months. A select few, I’m sure who are very honored, get to do this for a few years. But I’m talking about the hard-core sleep deprivation, when sleep lasts for only an hour or two at a time, twice per night and maybe snagging a few minutes here and there during the day (not always by choice…). It’s rough. Add to that a baby who is super hungry all the time and crying most of his or her waking time. Fortunately, the crying has lessened a bit as he moved into his tenth week.

I felt very desperate to solve the lack of sleep problem early on. Mostly because our first was sleepless (or so we thought) and we didn’t really do anything about it until she was eight or nine months old. I’ve read and re-read several books in the past few weeks. I am trying to make sense of infant sleeping and feeding problems so that I can solve the “problem” and get on with my life. And that, my friends, is exactly the problem.

Despite what all the “experts” say, there is no single way to approach how one cares for an infant. What I am finding out is that what we did for our first does not really apply to the second (so far). This also applies to what others have done for their children, will not necessarily work for mine. Others have some great ideas and I have tried many of them. Some work for us, some do not.

Child rearing is a process, not something that you just do and get it over with. Even in the infancy stage. Sure, you want to do what is best for your child. But we parents really can’t control everything. This is a lesson I am still trying to accept. It can be very difficult to just be in the moment, especially when the moment seems to drag on, and on, and on. For months.

The most helpful intervention I have used with my infant has been talking about it to others. My husband, my mother, my mother-in-law, my neighbor, other mothers in play groups, and even here in this post. We haven’t solved any of the “problems” by doing this, but I have gained much insight and valuable emotional strength to carry on. Infancy does not last long. And, if we did solve the crying/sleeping/feeding problem today, everything changes in the next week or month and what we do today will be completely irrelevant. Lovely.

The beautiful thing is that it doesn’t last forever and it makes you very tolerant of other things in the world, such as, well, I can’t even think of anything that bothers me right now because few things are as difficult to deal with as a screaming baby for six or eight hours. See? Instantly tolerant!

One of my favorite books for coping with a baby such as ours is Dr. Harvey Karp’s “The Happiest Baby on the Block.” I’ll post a book review soon. I think this has been a help to us, as well as to our son (and daughter). Another book I wanted to write a review on, but fear I would unleash more anger than I care to deal with right now, is “Baby Wise.” What a nightmare! I read it simply out of interest, knowing that it would probably go against my beliefs, values, personality, and general approach to parenting. I had no idea it was so bad. So now I know and I can move on. (In all fairness, for those of you with babies inclined to take to an early schedule and sleep alot, here is a blog by a parent who implements this technique, though I tend to agree with this blog more, as my children are not “easy.”)

When it comes to actually solving a sleep problem (which I believe cannot be done in the first three or four months, contrary to some beliefs), Dr. Richard Ferber’s “Solve Your Child’s Sleep Problems” has been an invaluable source. It’s not evil or verging on abusive (like “Baby Wise.” Oh, did I say that?) like it is made out to be by some people. I’ll post a review on that one, too.

What about you?

If you, dear reader, have had to deal with sleepless nights on account of a baby, what did you have to do to get through it? How did it change you? How do you look back on that time? Was there any advice others gave you that helped? Or advice that made things worse?

I knew that this baby was quite spunky from the way he behaved in the womb. Always kicking, no, thrashing about for several hours every night. He came into this world with a bang and hasn’t let up since. This boy has been nursing non-stop since he was born. I mean, he can go four hours, but that has only happened twice. Usually he will nurse every 30 minutes for about 8 hours a day. The rest of the time it is every 1-2 hours.

Now, they aren’t long, drawn out nursing sessions. He is finished after about five minutes. He has learned not to take too much at a time because he spits it all back up. He used to lose the whole “meal” several times a day. We figured out how to deal with the spitting up (thanks to Dr. Sears’ suggestions) and so that is less of an issue. Although, I am still changing my outfit (yes, the entire thing) one to three times a day.

For many babies, spitting up causes a weight gain problem. Not with this guy. He is, as of today, 14 lbs 12 oz. Okay, seven weeks and on our way to 6-9 month clothing!

Sleeping is also a big issue. Since he nurses so much, he sleeps very little. I mean, sometimes nine hours in a 24-hour period. He averages just under 12. For a newborn, that is very low. So he’s active, no problem, right? Wrong. Most of his waking time, if not nursing, he is crying. Loudly. Like an ambulance driving right through your living room. So, is something wrong with him? I don’t know.

Enter the medications: We started Zantac (against our wishes) with the hope of helping him be in less pain. His crying was often related to feeding, so he was diagnosed with reflux, or GER. After two weeks and no change, we have switched him to Prilosec, which is supposed to be more effective. Still, not a whole lot of difference. He may just be very vocal, or grow out of it eventually like so many babies do.

So how are we coping? More to come on that. I’ll write that bit as soon as I have another few minutes here and there to actually sit and use both of my hands!